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Adherence of self-monitoring of blood glucose in persons with type 1 diabetes in Sweden

Journal article
Authors P. Moström
Elsa Ahlén
Henrik Imberg
Per-Olof Hansson
Marcus Lind
Published in BMJ Open Diabetes Research and Care
Volume 5
Issue 1
ISSN 2052-4897
Publication year 2017
Published at Department of Mathematical Sciences
Institute of Medicine, Department of Molecular and Clinical Medicine
Language en
Subject categories Endocrinology and Diabetes


Objective: The primary aim was to evaluate the extent to which persons with type 1 diabetes perform selfmonitoring of blood glucose (SMBG) according to guidelines. Secondary objectives were to investigate predictors for good SMBG adherence, reasons for non-adherence, and association between SMBG frequency and hemoglobin A1c (HbA1c). Methods: This was a survey-based cross-sectional study. Questionnaires were sent out to 600 random patients at five sites. Patients were included if they were diagnosed with type 1 diabetes and ≥18 years old and excluded if they were currently using continuous glucose monitoring (CGM). Analysis of data was performed separately for the three sites where the answer frequency was ≥70%. Results: In total, 138 of 314 study participants, 43.9% (95% CI 38.5% to 49.4%) performed SMBG ≥4 times per day. For the three clinics where ≥70% of surveyed patients were included in the analysis, results were similar, 41.3% (95% CI 34.7% to 47.8%). Top three reported reasons for not performing more frequent SMBG were lack of time, not remembering, and self-consciousness. Frequency of SMBG was associated with HbA1c levels (p<0.0001). 30% of patients believed that ≤3 SMBG/day was recommended by healthcare providers. Conclusions: Less than 50% of patients in Sweden follow guidelines of SMBG ≥4 times per day, despite glucose meters and strips being generally available at no cost. This indicates a need for further support in performing SMBG and increased availability of other tools for glucose monitoring. © 2017, BMJ Publishing Group. All rights reserved.

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